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11197 (2) POST THIS CARD NEAR FRONT OF,BUbLDING �� PERMIT NUMBER CITY OF CUPERTINO 11197 INSPECTION DIVISION ' JOB INSPECTION RECORD /f,�E� E� PERMIT.EXPI RATION \• JOB ADDRESS O 2 '4 5 Cd VII �r ' UNIT# N LOT# 11 - PERMIT EXPIRES IF.WORK OWNER 'l�' CONTRACTOR • IS NOT STARTED,WITHIN " INSPECTION DATE INSPE TOR INSPECTION RECORD 180 DAYS OF,PERMIT ISSUi ,.1. r�� •�-G-� ANCE,OR A80 DAYS FROM' FOUNDATION (`, �/ /'r 4 LASTCALL'ED INSPECTION. LIFER �tl� `� tN' PERMIT VALIDATION PREGUNITE Ka•T�1" a\-Lcll. 954*1 .. - ' ?—L POURING CONCRETE UNTIL ABOVE HAS BEEN ZYGN ED UNDERGROUND /SLAB - PLUMBING ELECTRICAL ISSUANCE DATE •'MECHANICAL - - - BLDG.- ELECT. PLG. MEgR. ❑ , ❑ ` 0 DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUATION 'SIFT. PLUMBING -S7. 1 Y J MECHANICAL RM ELECTRICAL ' PE1 �ITr� - FRAMING INSULATION STORIES rvPE corysrR. I OCC,GROUP 'RES.UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED w _ ' - SQ FT.Fl00N AREA TOTAL ACREAGE ROOF _ DIAPHRAGM •-BUILD INN USE NES IND ' CON PB Other APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ❑ El ❑ ❑ ElASSESSORS PARCEL NO. ROUGH PLUMBING' -' - • 'TRACT NO. PARCEL NO. GAS TEST MECHANICAL ELECTRICAL - FINALS DATE INSP. ACC.DATE CC.FILE NO, FRAMING' . I SAN it '.ZONING ENG.SITE NO. INSULATION - PLUMBING - GAS MECHANICAL ' FIRE SPRINK ENERcv.Tza COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Q V N❑ v [D N❑ ELECTRICAL FLOOD ZONE A.L.U.C. LATH-INTERIOR v:❑-. N❑ wl] N[]LATH-EXTERIOR . - FIRE DEPT, 1p 11 SHEETROCK GRADE - FEE SUMMARY SHEAR-INTERIOR - - BUILDING„ ,_�;,,,. r•. SHEAR EXTERIOR TEMPORARY APPROVALS 'BUILDING , , FIREWALLS JELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE r, r, OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY.BUILDING INSPECTOR: MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, . ELECTRIC �! ',ONE WORKING DAY BEFORE REQUIRED INSPECTION.. PLUMBING� 0� PLEASE.GIVE JOB WHEN PHONING. Z . MECHANICAL — SEE PERMIT FOR EXPIRATIOWDATE IMPORTANT! CONST.TAX . PLEASE READ REVERSE SIDE BEFORE T' TOTAL, I CALLING FOR FINAL INSPECTION. OFFICE COPY. - — — —- — — - APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN'ONLY BU I LDING PROJECT I DENTIFICATI ON PERMIT NUMBER BUILDING APPLICATION & PERMIT ADDRESS 1197 ///----�� 7.I"7., ONb� C:R-I�OLUOd �•�zf/r=' BUILDING -ELECTRICAL-PLUMBING-MECHANICAL OWNtN) o si PLANCHECK ALIDATION I • f nl ELECTRIC PERMIT FEE MLTj' � 6 _ CONTRACTOR'S V NAME O OUTLETS-SWITCHES-RECEP 10.00/1.00 LIC.No. - LIGHTING FIXTURES 10.00/1.00 ogees TORS PPLIANCES-RESIDENTIAL '4.00 'HONE PANELS - 10.00 DATE OF APPLICATION OR ARCHITECTPLAN(OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. ENGINEER LIC.NO, SIGNS TRANS. 3.00 ARCH OR ADDRESS ENG. SPECIALCIRCUIT 5,00 PERMIT VALIDATION ZIP EMP.METER OR POLE INS. 20.00 I ADDRESSTs MOTORS SEE FEE SCH. �L!/ lC _ SERVICE CHANGE - 20.00 LICENSED CONTRACTORS DECLARATION 1 hereby affirm that I am licensed under provisions of Chapter 9 w IS UANOE DATE (commencing with Section 700e)i in Division 3 of the Business and i Professions Code,and my license is in full farce and effect - - BLDG. ELECT. PLG. MECH. 0 Z rm_n w Date Class Lin.Number INDr-C,�.r1 fYLX�'IIl Date Contractor a x s BUILDING PERMIT ic a w a OWNER-BUILDER DECLARATION °nU MISC.- REFER TO ORD INFORMATION w 3 1 hereby affirm that 1 am exempt from the Contractor's License MFE VALUATION S/FT. Fwo J Law for the following reason.(Sec.7031.5,Business and Professions PERMIT ISSUANCE 10.0Cade:Anycity orcounty which requires a permitto construct,alter, ¢ a 0 improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.N0. ELEC.Drequires the applicant for such permit to file a signed statement thatTOTALw$ he is licensed pursuant en the provisions of the Contractor's License eLaw(Cha nd Procosigns C de)0,Section is 00)exemft theron 3 and T'Business and Professions Code)or that hn is exempt therefrom and G PLUMBING PERMIT Ic H the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. w ; by any applicant for a permit subjects the applicant to civil penalty of not more than five hundred.dollars($500).) ALTER-DRAIN&VENT-WATER (EA.) 5.00 ❑ 1,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP REB.UNITS their sole compensation,,will do the work,and the structure is not intended or offered for sale(Sec..7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's License Law does not apply to an owner of property who builds or improves 1• thereon,and who does such work FIXTURES-PER TRAP 5.00 '' $0.FT,FLOOR AREA ,TOTAL ACREAGE �. himself through his own employees,provided that such improve- iare rnnot intended or offered for sale.If,however,the building GAS-EA.SYSTEM-1INC.4OUTLETS 6.00 I-� ormor improvement is sold within one year of completion,the owner- builder will have the burden of proving that he did hot build or am- GAS-EA.SYSTEM-OVER 4(EA.) 2.00 BUILDING USE ij prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 RES IND CON PB Omer ❑ d as owner of the property,am exclusively contracting with - El El 1:1 El .I Mnsed contractors 1.construct the project(Sec. 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. fi.00 ASSESSORS PARCEL NO. Professions Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such pmiceri with u contractorls)licensed pursuant to the Contractor's License Law. SEWER-SANITARY-STORM EA,200tt/10.00 TRACT NO. PARCEL NO. ❑ I am exempt under Sec. B.&P.C.for this WATER HEATER W/VENT 6.00 mason Owner Date Ah.ILPA. WATER SYSTEM 5.00 - ACC.DATE ACC.FILE NO. WORK ERS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 1 hereby affirm that I have a certificate of consent m self-insure, , or a certificate of Workers'Compensation Insurance,or a certified ZONING ENG.SITE NO. copy thereof(Sec.3800,Lab.CJ. Policy No. . company- 0 ompany 0 IDCertified copy is hereby furnished. Z 2 ❑ Certified copy is filed with the cily'inspeclion division. FIRESPRINK ENERGY T-24 O Applicant MISC.- REFER TO ORD, YE] NF] Y [] N[ p: rn - PERMIT ISSUANCE � - CERTIFICATEOFEXF-MPTION FROM WORKERS' 10.0016, FLOOD ZONE A.L.U.C. LU ? COMPENSATION INSURANCE FLG.CONTR. LIC.NO. PLC, ,i Z (This section need not be completed if the permit is for one TOTAL 3 d Y[3N❑ Y NE hundred dollars(S 100)or less.) U O 1 certify that in the performance of the work for which this per- Q Y• MECHANICAL PERMIT FEE FEE SUMMARY U. F mit is issued,I shall not employ any person in any manner so as to O w become subject to the Workers'Compensation Laws of California. y Date Applicant - ALTER OR ADD TO MECH. 5,00 BUILDING } Us NOTICE TO.APPLICANT: If,after making this Certificatefof E.- Z m I- emption,you should become subject to the Workers'Copensation APPLIANCE- 5.00 PLAN CHECK L.1 provisions the Libor Code, you must forthwith comply with - FEE such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10p00QF.M.1 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 100000F.M.) 6.00 SEISMIC FEE ,3 9g I hereby affirm that there is a constructionlending agency for EXHAUST HOOD(WITH DUCT) 5.00 the performance of the work for which this permit is issued ISec. MICROFILM 3097,Civ.C.). HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name H EATI NG UNIT(OVER 100,000 B.T.U.)9.50 Lender's Address ELECTRIC FQ •�' - I certify that I have read this application and stole that the above VENTILATION FAN (SINGLE) 4.00 information is correct.I agree to comply with all city and county g01LER.COMP 13 H.P.Or 100,000 B.T.U.) 6.00 PLUMBING 30 - ordinances and state laws relating to building con am and hereby authorize representatives ins ect this city to enter upon the BOILER- OMP(Over 100,000 B7U)BEE FEE SCH. MECHANICAL above-mentioned property forinsp of thi purposes. (We) agree to save, indemnify and keep harnsless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which PERMIT ISSUANCE 10.00 s CONST.TAX may any way scene aPAfnit viJ City in conseyuence of the 1d' gran n of[his permit �� /3 MECH.CONT. LIC.NO.' MECH. / �-� tT� �Y� TOTAL �Fi TOTAL 35� SlgnaNreof Apphcanl/Contractor I7 ])are OFFICE COPY